Pregnancy morning sickness is one of the most talked-about symptoms of early pregnancy—and one of the most misunderstood. While many assume it’s just a standard part of the first trimester, the reality is far more complex.
Morning sickness – the nausea and vomiting that often come with pregnancy – is incredibly common, affecting up to 70–80% of pregnant women . If you’re expecting and battling queasiness, you’re far from alone. Still, knowing that doesn’t always make it easier when morning sickness hits hard.
This blog will explain why pregnancy nausea happens, the types of morning sickness women often experience, and how to cope. We’ll also discuss why the usual advice (like “eat some ginger” or “try crackers”) doesn’t always work for everyone, backing it up with research.
By understanding your type of morning sickness, you can find better relief and feel more in control. And remember, this phase does pass, and there are plenty of options to help you feel better in the meantime.
What Causes Morning Sickness?
It’s natural to wonder why you’re feeling so nauseous. The truth is, the exact cause of morning sickness isn’t 100% certain, but experts believe it’s due to a mix of hormonal and physical changes in early pregnancy.
Here are some key factors and what research says about them:
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1Surging Hormones
In early pregnancy, levels of hormones like human chorionic gonadotropin (hCG) and estrogen skyrocket. Studies suggest that rising hCG produced by the placenta is a major trigger for nausea and vomiting.
People with higher hCG (for example, those pregnant with twins or multiples) are more likely to have severe morning sickness {mayoclinic.org}. Elevated estrogen, another hormone that increases in pregnancy, is also linked with worse nausea. Your body needs these hormones for a healthy pregnancy, but unfortunately, they can make you feel pretty miserable.
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2Sensitive stomach and Slowed digestion
Pregnancy hormones (especially progesterone) relax smooth muscles, including those in your digestive tract. This can slow down how quickly your stomach empties, potentially leading to that full, queasy feeling and heartburn. An empty stomach can also trigger nausea – a bit of a Catch-22! Many women find their nausea is worst when they haven’t eaten in a while, because low blood sugar may play a role.
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3Heightened Sense of Smell
Ever since you became pregnant, have certain smells sent you running for the bathroom? You’re not imagining it – about two-thirds of pregnant women report a stronger sense of smell (hyperosmia) during early pregnancy.
Often those heightened odors aren’t pleasant and can instantly turn your stomach. Experts believe this could be the body’s way of protecting you from foods that might be harmful in pregnancy. For example, the smell of smoke, garbage, raw meat, or even your partner’s cologne might suddenly make you gag. This super-smelling ability usually fades later in pregnancy, but in the first trimester, it can be intense.
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4Genetic and Personal Factors
Every woman is different. If your mother or sister had bad morning sickness, you might be more prone to it. Those who are prone to motion sickness or migraines also seem to experience worse nausea in pregnancy. Stress and fatigue can also contribute—being exhausted or anxious tends to make that queasy feeling more pronounced. -
5A Protective Purpose
Interestingly, some scientists theorize that morning sickness has an evolutionary advantage. Feeling repulsed by certain foods (like the smell of spoiled meat or strong-tasting plants) would steer early pregnant women away from potentially toxic substances. In essence, nausea might be nature’s way of guarding the developing baby.While this theory isn’t proven, it’s a small silver lining to think your body might be trying to protect you. Also, research has noted that women who do experience nausea have a slightly lower risk of miscarriage on average – possibly because those pregnancy hormones are strong. (Don’t worry if you’re NOT sick, though – plenty of women have healthy pregnancies with minimal nausea.
In short, morning sickness is usually caused by pregnancy hormones and body changes. The nausea can be a sign that your pregnancy hormones are high (a good thing for baby), but it sure doesn’t feel good for you. Understanding these causes helps explain why the symptoms vary so much – and as we’ll see, there isn’t just one kind of morning sickness.
Five Types of Morning Sickness (One Size Doesn’t Fit All)
Every pregnancy is unique, and nausea can show up in different ways. Many moms are surprised when the usual “morning” sickness isn’t just in the morning, or when one remedy works for their friend but not for them. Researchers and healthcare providers have observed that pregnancy nausea generally falls into a few patterns.
Here we’ll describe five common “types” of morning sickness. See which one sounds most like what you’re experiencing – it may help you tailor your approach and find the right relief.
1. Classic Morning-Only Sickness
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Why it Happens
For some women, nausea is primarily a morning affair. You wake up with an upset stomach, maybe dry-heave or vomit bile, and feel awful… but by afternoon or evening, you’re relatively okay. This classic pattern is what gave “morning sickness” its name.
Why morning?
After a night’s sleep, your stomach is empty and your blood sugar is low – a perfect recipe for nausea. Those hCG levels also tend to be high during the early part of the day. The result: you feel queasy upon waking and often can’t face breakfast.
If you have morning-only sickness, you might find that *eating something bland immediately after waking helps. Obstetricians commonly recommend keeping crackers at your bedside and nibbling a couple before you even sit up . The idea is to raise your blood sugar a bit and give your stomach a little sponge to soak up acid.
According to Dr. Aaron Caughey (OB/GYN and author of ACOG’s guidelines on nausea), hypoglycemia (low blood sugar) can lead to a nausea spiral – you’re so nauseous you don’t eat, which makes the nausea worse. Breaking that cycle with a small carb snack can really help this morning type of sickness. Also, get up slowly – sudden movements can worsen the dizziness and nausea.
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Why standard remedies might not work:
If your nausea is primarily due to an empty stomach in the morning, drinking ginger tea or sniffing peppermint oil might not be enough. Ginger has some anti-nausea properties, but it doesn’t correct the underlying low blood sugar. So, if you only try ginger and still skip breakfast, you may not feel better.
The key to morning-type sickness is to preempt the emptiness: eat before you get hungry. Many women find that a combination of strategies works best (for example, crackers, ginger tea, and moving slowly). The good news is that this type usually eases up once you get food daily.
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Tips for Relief
- Eat before getting up: Keep crackers or dry cereal by your bed and nibble a little before you even sit up.
- Rise slowly: Give yourself time when getting out of bed. Sudden moves can worsen the wave of nausea.
- Protein at bedtime: A small high-protein snack (like cheese or peanut butter toast) before sleep may keep your blood sugar steadier till morning.
2. All-Day Nausea and Queasiness
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Why it Happens
Another common pattern is feeling queasy all day, from morning till night. With this type, you might not vomit frequently (or at all), but the nausea is constant and wearing you down hour after hour. It can feel like a never-ending bout of seasickness or a hangover that lasts for weeks. This happens because for some women, those hormone levels are high enough – or your stomach is sensitive enough – that the unsettled feeling never fully lets up throughout the day.
If you have all-day nausea, you’re probably desperate for something to take the edge off so you can function. Typical advice like “eat small frequent meals” is given because it really can help keep your stomach from crashing. Grazing on plain, light foods (crackers, toast, fruit, nuts) every 1–2 hours prevents your tummy from getting empty or producing excess acid.
Staying hydrated is equally important; sip fluids continuously (water, ginger ale, electrolyte drinks – whatever you can tolerate) to avoid dehydration. Vitamin B6 supplements have been shown to improve nausea in some women, and doctors often recommend B6 for persistent nausea (usually 25 mg, three times a day – but ask your doctor about the correct dose for you). Some women also wear acupressure wrist bands (like Sea-Bands) which press on a point on the inner wrist; evidence on these is mixed, but a number of moms swear by them, and they are safe to try.
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Why standard remedies might not work:
All-day pregnancy nausea can be tough because it’s multifactorial. An occasional ginger candy might help for a short time, but then the queasiness creeps back. Medical reviews have found that while ginger is somewhat effective, the evidence is limited and inconsistent – it’s not a universal cure. The same goes for vitamin B6 and other over-the-counter aids: they help some women a bit, and not others.
If you’re nibbling crackers non-stop and still feel ill, don’t be afraid to talk to your healthcare provider. Some safe anti-nausea medications can be prescribed when diet and home remedies aren’t enough. Remember: You do not have to suffer in silence just because nausea is common. When it drags on all day and affects your quality of life, seeking additional treatment is perfectly okay.
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Tips for Relief
- Small, frequent snacks: Never let your stomach get completely empty. Graze on bland foods (toast, pretzels, yogurt, nuts) every 1–2 hours.
- Stay hydrated: Take frequent sips of water, ginger ale, or electrolyte drinks. Sucking on ice chips or popsicles can help if drinking is hard.
- Vitamin B6: Consider a vitamin B6 supplement (ask your doctor for the right dose) – it’s been shown to help mild nausea in some women
- Rest and destress: Fatigue and anxiety worsen nausea. Take short naps or practice relaxation techniques (deep breathing, prenatal yoga) to calm your system.
3. Food- and Smell-Triggered Nausea
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Why it Happens
Do certain odors or foods set off your nausea instantly? Many pregnant women experience this type of morning sickness, feeling mostly fine until they smell that leftover curry, open the fridge, or walk past the coffee shop. Suddenly, your gag reflex kicks in. In this pattern, specific triggers – usually strong smells or sometimes the texture/appearance of certain foods – are the culprits behind your queasiness. It’s no wonder, as mentioned earlier, that about 66% of pregnant women report a heightened sense of smell, and usually not in a good way. Those “foul” or overly strong smells can provoke nausea and vomiting.
Common triggers include cooking odors (especially meats, fried foods, eggs), perfume or chemical smells, garlic or onion, coffee, and even the smell of your refrigerator or trash can. Sometimes, even thinking about a certain food can turn your stomach in pregnancy! This type is often linked with strong food aversions – for example, you might normally love chicken, but now just the thought of chicken makes you retch.
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Why standard remedies might not work:
If your nausea is trigger-driven, a generic remedy like ginger might not stand a chance if you’re, say, stuck in a smelly aisle of the grocery store. The cause here is sensory – your nose and brain react to an odor. The fix has to involve either avoiding the trigger or masking it.
That’s why someone telling you to “just eat a cracker” can feel useless – a cracker won’t magically make the garbage smell disappear. For this type, think of remedies in terms of your environment: fresh air, fragrance-free everything, and enlisting those around you to help minimize triggers. The good news is that this hypersensitivity tends to ease up by mid-pregnancy for most women. Until then, do whatever you need to do (within reason) to avoid the nausea landmines – even if it means temporarily banning all cooking of broccoli in your house!
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Tips for Relief
The obvious solution is to avoid triggers as much as humanly possible. Of course, you can’t live in a bubble, but small adjustments help.
- Avoid and adapt: Identify your nausea triggers and do your best to avoid them (e.g., if the smell of cooking meat makes you sick, let someone else cook or choose different foods).
- Fresh air and ventilation: Keep windows open while cooking, and use fans to disperse odors. When a smell overwhelms you, stepping outside for a few minutes can help.
- Use scent strategies: Sniff lemons or ginger, chew mint gum, or carry a handkerchief with a drop of lemon or peppermint oil to mask unpleasant odors. Pleasant scents can block nasty ones.
- Cold or room-temp foods: These smell less than hot foods, so you might tolerate a cold turkey sandwich better than grilled chicken, for example.
4. Evening (Late-Day) Sickness
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Why it Happens
While mornings get all the press, many expecting moms find that their nausea actually worsens in the late afternoon or evening. You might sail through the first part of the day feeling fine, only to crash onto the couch feeling green by dinnertime. Evening sickness is absolutely a real thing – pregnancy nausea can strike at any hour .
In this type, fatigue likely plays a significant role. By later in the day you’re tired, your blood sugar may dip if you haven’t eaten recently, and all the day’s odors and stressors have accumulated. Some women also experience acid reflux or heartburn later in the day (especially if eating larger dinners or lying down after meals), and that can manifest as nausea.
Several factors might contribute to late-day nausea. One is simply that the hormonal surges continue throughout the day – it’s not like hCG turns off after noon. Some studies have noted up to 80–90% of pregnant women experience nausea at various times, not just morning.
Additionally, triggers like feeling too hungry or full can catch up with you in the evening. Many women feel okay at work and then realize they forgot to snack or drink enough fluids, and by evening, their bodies rebel. Lying down can also provoke nausea or vomiting for some (possibly due to acid reflux), so if you lie down soon after dinner, you might start to feel sick.
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Why standard remedies might not work:
If you’re feeling fine in the morning, the typical “morning sickness” advice of nibbling crackers at the bedside isn’t addressing your problem. For late-day sickness, prevention during the day is key. Sometimes women don’t connect that their evening nausea is related to not eating enough earlier, or being on their feet too much. A ginger ale at night might soothe you temporarily, but it won’t fix fatigue or low blood sugar.
That’s why focusing on self-care throughout the day is so important for this pattern. Also, if you only feel sick at night, you might be tempted to tough it out – but do mention it at prenatal visits, especially if it’s consistent. Your provider can check if maybe you have reflux that could be treated, or give other suggestions. Remember, “morning” sickness doesn’t follow a clock – and whenever it strikes, you deserve relief.
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Tips for Relief
- Don’t skip meals: Ensure you eat enough during the day. An afternoon snack with protein and complex carbs can keep evening nausea at bay.
- Light early dinner: Opt for a lighter supper and eat it earlier in the evening. Avoid greasy or spicy foods at night, which can trigger nausea/reflux.
- Stay upright after eating: Give yourself an hour (or two) before lying down after dinner. If you need to rest, prop up with pillows to keep your head elevated.
- Evening relaxation: Try to wind down stress in the evening – a calm mind can ease a turbulent tummy. A warm bath or prenatal massage (if approved) might help you feel better.
5. Hyperemesis Gravidarum (Severe Persistent Nausea/Vomiting)
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Why it Happens
Severe cases of morning sickness (hyperemesis gravidarum) can involve relentless vomiting and require medical attention. In a small percentage of pregnancies, morning sickness becomes extreme and unrelenting. This condition is known as hyperemesis gravidarum (HG), and it goes far beyond the normal range of nausea.
With HG, vomiting can occur multiple times a day – sometimes dozens – and nausea is constant. Women with hyperemesis often lose weight (over 5% of pre-pregnancy weight) and become dehydrated, since they can’t keep enough food or fluids down. This level of sickness is debilitating. It can land you in the hospital for IV fluids and medication, and it takes a significant physical and emotional toll. (Princess Kate famously suffered from hyperemesis in her pregnancies, bringing more awareness to how severe it can be.)
Fortunately, hyperemesis gravidarum is rare—estimates vary, but roughly 1–3% of pregnant women experience HG . Researchers have recently made progress in understanding HG. A 2023 study identified a placenta-produced hormone called GDF15 as a key culprit; women who are more sensitive to this hormone get the sickest, suggesting a biochemical cause for HG .
There may also be genetic factors, as HG tends to recur in families and the same woman’s subsequent pregnancies. The main thing to know is that hyperemesis is not your fault – you haven’t “failed” to cope, it’s a serious medical condition. No amount of ginger or crackers will touch true hyperemesis.
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Why standard remedies might not work:
This one is probably self-explanatory – hyperemesis is beyond the reach of typical home remedies. It’s not because you’re weak or not trying hard enough; it’s because the physiology (perhaps GDF15 hormone sensitivity, for example) is overpowering the usual controls. As one woman with severe morning sickness noted, ginger tea and “it’ll pass” attitudes did literally nothing for her.
In cases of HG, continuing to only try ginger, crackers, acupressure, etc., without medical intervention can actually be dangerous, as dehydration and weight loss can threaten you and the baby. So, the standard remedies “fail” here because the condition itself is much more severe than normal nausea.
The mismatch is like trying to treat a migraine with a tiny bandage – it’s just not enough. The only practical approach is medical management combined with coping strategies to get you through the day-to-day. If you’re reading this and suffering from HG, please know you’re not alone and it’s okay (in fact, necessary) to get proper treatment.
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Tips for Relief
- Seek medical care: Don’t wait – call your doctor or midwife. You may need IV fluids for dehydration and prescription medications to control vomiting.
- IV nutrition/hydration: In severe cases, doctors can give you nutrients and fluids through an IV. This can dramatically improve how you feel once dehydration is corrected.
- Try to eat/drink tiny amounts: Even if almost everything comes back up, keep trying small sips of fluid (water with a squeeze of lemon, electrolyte drinks, ginger tea) and small bites of bland foods. Something is better than nothing, and on better moments, those bits add up.
- Support and rest: Enlist help from family/friends for daily tasks. Rest as much as possible. Consider joining a support group for HG – talking to others who understand can provide emotional relief.
Why One-Size-Fits-All Remedies Often Fail
By now, you’ve seen that morning sickness isn’t a single uniform experience, so it makes sense that a single remedy won’t magically work for everyone. Yet many of us are told the same tips: eat dry toast, drink ginger ale, take vitamin B6, etc. These are all fine suggestions (and do help many women), but what if you’ve tried them all and you’re still nauseous? You might feel frustrated or even wonder if you’re doing something wrong. Rest assured, it’s not you – it’s the approach.
Research supports what pregnant women have long suspected: there’s no one-size-fits-all cure for morning sickness. The U.K. health service (NHS) frankly states, “unfortunately, there’s no hard and fast treatment that will work for everyone’s morning sickness. Every pregnancy will be different. Similarly, obstetricians acknowledge that no single approach works for all women, and often it’s a process of trial and error with various strategies.
Each Type Responds to Different Remedies
Part of the reason is that each of the nausea “types” we described may respond to different things. For example, if your nausea is from smell triggers, you’ll get more mileage out of avoiding triggers and sniffing lemon than you might from taking vitamin B6. Conversely, if your nausea is due to hormonal surges causing all-day sickness, you might need a combination of dietary changes and perhaps medication.
Studies have found mixed results on common remedies – for instance, ginger has shown only limited effectiveness in clinical trials overall, yet some women swear by it anecdotally. Vitamin B6 helps take the edge off for some, but not all Because of these variations, medical guidelines often recommend a stepwise approach:
1. Try diet/lifestyle changes.
2. Then move to supplements like B6 or ginger.
3. If needed, consult your doctor and try anti-nausea medications.
Don’t be discouraged if the first things you try don’t work – you may need a different tactic.
When to See a Doctor
Most of the time, morning sickness can be managed with lifestyle measures, and it will improve as you enter the second trimester. However, listening to your body and seeking medical advice is crucial if things get too intense. Call your OB/GYN or midwife if you experience any of the following:
- Signs of dehydration: If you cannot keep liquids down and notice you’re hardly urinating or your urine is very dark, that’s a red flag. Dizziness or feeling faint, especially when standing, and a racing heartbeat can also signal dehydration.
- Persistent vomiting: Vomiting more than 3–4 times a day, or every time you eat or drink, is not normal and warrants medical attention. You may need medication to break the cycle and prevent malnutrition.
- Weight loss: A small weight drop in early pregnancy can happen, but if you’ve lost 5% or more of your pre-pregnancy weight due to nausea/vomiting, contact your provider.
- Vomiting blood or severe pain: If you ever vomit blood (even small streaks) or have severe abdominal pain with your nausea, seek care promptly. These could indicate something other than typical morning sickness (like a stomach ulcer or another illness).
- Onset of nausea after 9 weeks: Morning sickness typically starts early (between 5–9 weeks) and eases by 14–16 weeks. If you suddenly develop new nausea and vomiting later in pregnancy, talk to your doctor – sometimes other conditions (like a stomach bug, gallbladder issue, or reflux) could be the cause.
Trust your instincts. If you feel something isn’t right or you’re just utterly miserable, please reach out to your healthcare provider.
Conclusion: Each Pregnancy Experience is Different
Growing a baby is hard work, and dealing with morning sickness can be one of the toughest parts of early pregnancy. For most women, the nausea significantly improves or completely disappears by the start of the second trimester (around week 14). Each day, your placenta is getting better at supporting your baby, and your hormones will eventually level out. In the meantime, give yourself grace. It’s okay if you’re not enjoying every moment of pregnancy – feeling sick all day is draining, and it’s normal to feel down about it at times.
However, there’s hope: many women find their symptoms manageable with the right combination of remedies. It might take some experimentation, and what works can be very personal. Embrace whatever helps you personally (as long as it’s safe!).
Check out our other Pregnancy Blogs —
Hyperemesis Gravidarum: Understanding Pregnancy Complications
How Your Third Trimester Pregnancy Nutrition Impacts Your Baby’s Brain
REFERENCES:
Researchers identify key cause of pregnancy sickness and a potential way to prevent it
Pregnancy week by week | Mayo Clinic
Nausea and Vomiting During Early Pregnancy
Heightened sense of smell during pregnancy
Are Smell Aversions Linked to Morning Sickness?
Can You Get Morning Sickness at Night?
Morning Sickness: Nausea and Vomiting of Pregnancy | ACOG
Women Say Ginger Doesn’t Tame Morning Sickness
Interventions for nausea and vomiting in early pregnancy